Exploring perceptions of common practices immediately following burn injuries in rural communities of Bangladesh

Trends and cross-country inequalities in global burns burden among children and adolescents: A population-based study from 1990 to 2021

BACKGROUND

Burns among children and adolescents represent a significant global health burden, leading to substantial morbidity and disability. This study aimed to analyze the trends in burn incidence, prevalence, and years lived with disability (YLDs) from 1990 to 2021, and to project future trends to 2035, highlighting global and regional disparities.

METHODS

We utilized data from the Global Burden of Disease (GBD) database covering 204 countries and territories. Burn data were extracted from multiple sources including hospital records, health surveys, and national health databases. Trend analysis was projected using the Bayesian age-period-cohort (BAPC) model. Health inequality was assessed using the slope index of inequality (SII) and the concentration index (CI).

RESULTS

In 2021, the global incidence of burns among children and adolescents was 8,484,254 cases, with an age-standardized incidence rate (ASIR) of 1315.94 per 100,000 population, showing an annual reduction of 1.33 % from 1990. The prevalence and YLDs also showed significant annual declines. Males had higher incidence rates than females. Younger children (0-4 years) experienced the highest incidence rates, while adolescents (15-19 years) had the highest prevalence. Regional disparities were evident, with Central Asia and Central Europe having the highest ASIRs. The SII and CI indicated persistent socio-economic health disparities, with lower socio-demographic index (SDI) countries bearing a disproportionate burden. Predictive analysis suggests a continued decline in burn incidence, prevalence, and YLDs through 2035. Additionally, burns among adolescents and young adults result in significant loss of labor force, exacerbating socio-economic challenges in affected regions.

CONCLUSION

The global burden of burns in children and adolescents has decreased significantly, yet substantial disparities persist across different regions and socio-economic strata. Continued efforts in improving burn prevention, treatment, and rehabilitation are essential to further reduce the burden and address health inequalities.

Associations of urban versus rural patient residence on outcomes after burn: A national inpatient sample database study

INTRODUCTION

Burn patients in rural areas may encounter poorer outcomes associated with barriers to care; however, residence has not been studied in a large sample. The association between rural-versus-urban residence and outcomes after burn was examined using the National Inpatient Sample (NIS) database.

METHODS

Using the 2019 NIS database, patients over 18 years with a primary diagnosis of burn or corrosive injury were included. Level of urbanization was categorized into six groups. Outcomes after burn such as in-hospital mortality, multifactorial shock, prolonged mechanical ventilation, length of stay, and total costs were analyzed after adjusting for demographic factors and hospital characteristics.

RESULTS

We included 4671 records, which represented a weighted population of 23,085 patients. Rural residence was associated with higher percentage of prior transfer but not in-hospital mortality. Compared to the most urbanized counties, encounters from the most rural counties were associated with higher odds of shock (aOR:2.62, 99% CI: 1.04-6.56, p = 0.007).

CONCLUSION

Burn encounters from less urbanized counties did not experience differences in mortality, rates of skin grafting, prolonged mechanical ventilation, length of stay, or overall costs. However, odds of shock were higher among the least urbanized counties. Despite improved triage and transportation systems across the US, disparities and challenges exist for burn patients from rural residence.

Factors associated with emergency department disposition among burn injury patients: Analysis of prehospital and emergency care characteristics using South Asia Burn Registry (SABR) data

INTRODUCTION

Improvement in burn injury data collections and the quality of databanks has allowed meaningful study of the epidemiologic trends in burn care. The study assessed factors associated with disposition of burn injury patients from emergency department accounting for pre-hospital care and emergency care.

METHODS

This prospective observational pilot study of the South Asia Burn Registry project was conducted at selected public sector burn centers in Bangladesh and Pakistan (September 2014 - January 2015). All age groups with an initial presentation to the burn centers were enrolled. Descriptive and regression analysis is presented.

RESULTS

A total of 2749 patients were enrolled. The mean age was 21.7 ± 18.0 years, 55.3% were males, and about a quarter were children < 5 years. About 46.9% of the females were housewives. Scald burns were common among children (67.6%) while flame burns were common among adults (44.3%). About 75% of patients were brought in via non-ambulance mode of transport. More than 55% of patients were referrals from other facilities or clinics. The most common first aid given pre-hospital was the use of water or oil. About 25% were admitted for further care. The adjusted odds of being admitted compared to being sent home were highest for children < 5 yrs, those with higher total body surface area burnt, having arrived via ambulance, scald and electrical burn, having an associated injury and inhalational injury.

CONCLUSION

The study provides insight into emergency burn care and associated factors that influenced outcomes for patients with burn injuries.

The epidemiology and characteristics of injuries to under 5's in a secondary city in Uganda: a retrospective review of hospital data

Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathered. This paper presents findings from a retrospective hospital record review of 4 hospitals in Jinja, a rural setting in Uganda, involving the extraction of data for children under the age of 5-years who sustained an injury during a 6-month period in 2019. A total of 225 injury cases were retrieved from the hospitals. Over half (57.3%) of the events occurred among males. The majority (92%) suffered one injury per injury event. Most of the injuries occurred among those aged 13 to 24 months (32.9%). Burns (32%) and cuts (20%) were the most common cause of injury. This study presents a hospital-based analysis of injuries amongst under 5's in rural Uganda. It provides information on the characteristics of children entering healthcare facilities in Uganda and highlights the burden of paediatric injuries in the hospital setting.

A survey of YouTube videos as a source of useful/un-useful information in the field of the prevention and management of burn injuries: A cross-sectional analysis of the English language content

The study was designed on whether YouTube videos are useful as an information resource in the field of burn injury prevention and management. Current literature on the educational content and quality of burn-related first aid videos on YouTube was reported as inadequate and inaccurate. However, the quality of YouTube videos on various medical and clinical topics has been the subject of many previous studies, and there has been increasing evidence that the content ratio of usefulness was higher than that of non-useful. While hours and even minutes in burn injuries are as precious as gold in terms of outcomes, it would be a significant loss not to use the most popular and easily accessible free social media platform of our time as a tool that can contribute to the prevention of burns and raise awareness. Analysis was conducted with the remaining 96 videos from 240 videos obtained from YouTube, according to possible search terms and exclusion of videos according to predetermined criteria. The Global Quality Score (GQS) and modified DISCERN (m.DISCERN) tools were used to assess the quality and reliability of the videos. Viewer engagement metrics and video properties were also investigated according to the usefulness criteria (e.g., video length, duration on YouTube, topic contents, source uploads, reliability, and quality). Finally, it was revealed that nearly 80 percent of the YouTube videos contained information in the field of the prevention and management of burn injuries deemed useful in this study, comparable to the other medical disciplines' reports in the literature.

Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community-level research

The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation's guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial.